Postoperative recurrence of atypical odontoma: a case report

Background: The purpose of this study was to analyze a case of recurrent atypical odontoma after surgical resection, in order to provide some references for the etiology analysis and treatment of this disease. Methods：The detailed clinical data and history of related clinical symptoms of this patient were retrieved at first visit. Intraoral examination showed permanent dentition, no left maxillary first premolar (24). However, there were several anomalous tooth-like tissues in the affected area. Imaging studies showed several small, highly dense image aggregates above tooth 24. The erupting and un-erupting teeth-like tissues were removed in accordance with the surgical method of extraction of supernumerary teeth under local anesthesia. The patient was returned to our clinic one month later, and periapical radiography examination showed irregular and unorganized radiopaque mass surrounded by a clear thin radiographic halo above the crown of tooth 24. The imaging data indicated that this was a typical manifestation of odontoma. After full communication with the child's parents, the second surgical resection was performed to remove the cyst wall and the hard tissue inside the capsule. Results: When the patient returned 3 months after the second operation, the intraoral examination showed tooth 24 had erupted normally, and periapical radiography examination showed no abnormal root development. Conclusion: The case gives us three inspirations: atypical odontoma is easy to cause misdiagnosis and lead to incomplete resection and postoperative recurrence; Intraoperative stimulation can promote the rapid growth of odontoma. Young permanent teeth can erupt normally after removing mechanical blockages without special treatment.